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1、羊膜移植与结膜瓣遮盖在角膜溃疡治疗中临床疗效的对比观察作者：苗培建，崔建萍，杨玲单位：221002)中国江苏省徐州市眼病防治研究所徐州市第一人民医院眼科【摘要】目的：分析羊膜移植与结膜瓣遮盖在角膜溃疡治疗中的临床疗效，探讨其在角膜溃疡治疗中的不同手术适应范围，为临床治疗提供循证医学依据。方法：冋顾性分析我院200410/200907行羊膜移植或结膜瓣遮盖手术治疗的角膜溃疡住院患者46例47眼，其中病毒性角膜溃疡13例14眼，真菌性角膜溃疡19例19眼，细菌性角膜溃疡7例7眼，蚕食及边缘性角膜溃疡3例3眼，无菌炎症性角膜
2、溃疡2例2眼，手术引起角膜内皮失代偿致角膜上皮大泡、溃疡2例2眼;穿孔9例9眼。上述患者行病灶清除+羊膜移植或结膜瓣遮盖手术治疗，行羊膜移植17例18眼，结膜瓣遮盖29例29眼，其中结膜瓣遮盖后行角膜移植2例2眼，术后针对原发病进一步进行药物治疗。结果：羊膜移植治疗后，治愈13例14眼，治愈率为78%(14/18)；行结膜瓣遮盖治疗后，治愈23例23眼，治愈率为79%(23/29)；二者在临床治愈率上没有明显的差别(P>0.05)o结论：羊膜移植与结膜瓣遮盖根据不同的溃疡类型及不同的溃疡发展进程选择合适的手术方式可以达
3、到较好的手术疗效。【关键词】羊膜移植；结膜瓣遮盖；角膜溃疡ComparativestudyofclinicalefficacybetweenamnioticmembranetransplantationandconjunctivalflapcoveringsurgeryinthetreatmentofcornealulcerseiJianMiao,JianPingCui,LingYang,ZhengPeiZhangEyeInstituteofXuzhou,EyeHospitalofXuzhou,Xuzhou221002
4、、JiangsuProvince,ChinastractAIM:ToprovideevidenceforEvidenceBasedMedicineonclinicaltreatmentofcornealulcersbyanalyzingtheclinicalefficacybetweenamnioticmembranetransplantationandconjunctivalflapcoveringsurgery,inaddition,toexplorethedifferentsurgicaladaptabiliti
5、esforeachtreatmentofcornealulcers・METHODS:Thisretrospectivereviewcomprised46casesofhospitalizedcornealulcerspatients(47eyes)whohadamnioticmembranetransplantationorconjunctivalflapcoveringsurgeryfromOctober2004toJuly2009,including13cases14eyeswithviralcornealulce
6、r,19cases19eyeswithfungalcornealulcer,7cases7eyeswithbacterialcomealulcer,3cases3eyeswitherosionandmarginalcornealulcer,2cases2eyeswithsterileinflammatorycornealulcer,2cases2eyeswithcornealepithelialbullaeandulcersforcornealendothelialdecompensationcausedbyoptic
7、alsurgery,9cases9eyeswithperforation.Allthepatientsweretreatedwithremovalofthenecroticcornealtissuecombinedwithamnioticmembranetninsplantationorconjunctivalflapcoveringsurgeryandthenweretreatedwithdnigsbasedonprimarydisease.RESULTS:Wefound17cases18eyestreatedwit
8、hamnioticmembranetransplantation,29cases29eyestreatedwithconjunctivalflapcoveringsurgeryinwhich2cases2eyeshadcornealtransplantationthereatte匚13cases14eyestreatedwitha
